Endocrinology Department, Pacific Neuroscience Institute, John Wayne Cancer Institute, Santa Monica, CA, USA.
Metabolic Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institutes of Health (NIH), Bethesda, MD, USA.
Horm Metab Res. 2020 Aug;52(8):562-577. doi: 10.1055/a-1089-7870. Epub 2020 Feb 10.
The diagnostic modalities, stratification tools, and treatment options for patients with thyroid cancer have rapidly evolved since the development of the American Thyroid Association (ATA) guidelines in 2015. This review compiles newer concepts in diagnosis, stratification tools and treatment options for patients with differentiated thyroid cancer (DTC), medullary thyroid carcinoma (MTC) and anaplastic thyroid cancer (ATC). Newer developments apply precision medicine in thyroid cancer patients to avoid over-treatment in low risk disease and under-treatment in high risk disease. Among novel patient-tailored therapies are selective RET inhibitors that have shown efficacy in the treatment of MTC with limited systemic toxicity compared with non-specific tyrosine kinase inhibitors. The combination of BRAF and MEK inhibitors have revolutionized management of mutant ATC. Several immunotherapeutic agents are being actively investigated in the treatment of all forms of thyroid cancer. In this review, we describe the recent advances in the diagnosis and management of DTC, MTC, and ATC, with an emphasis on novel treatment modalities.
自 2015 年美国甲状腺协会（ATA）指南发布以来，甲状腺癌的诊断方式、分层工具和治疗选择迅速发展。本综述汇集了分化型甲状腺癌（DTC）、甲状腺髓样癌（MTC）和间变性甲状腺癌（ATC）患者诊断、分层工具和治疗选择的新概念。新的发展将精准医学应用于甲状腺癌患者，以避免低危疾病过度治疗和高危疾病治疗不足。在新型个体化治疗中，选择性 RET 抑制剂在治疗 MTC 方面显示出了疗效，与非特异性酪氨酸激酶抑制剂相比，其全身毒性有限。BRAF 和 MEK 抑制剂的联合使用彻底改变了突变型 ATC 的治疗方法。几种免疫治疗药物正在积极研究用于治疗所有类型的甲状腺癌。在本综述中，我们描述了 DTC、MTC 和 ATC 的诊断和管理方面的最新进展，重点介绍了新的治疗方式。
